Biomedical Engineering Reference
In-Depth Information
This chapter will elaborate the role of surfaces in the transmission of pathogens.
Particular emphasis is laid on the current knowledge of the survival time and
conditions favouring survival of the pathogens. Finally, mechanisms of transmis-
sion from inanimate surfaces to patients are highlighted.
Within the multi-barrier strategy of the prevention of HAI, environmental
disinfection policies should be based on risk assessments for surfaces with different
risks for cross contamination such as high- and low-touched surfaces with appro-
priate standards for adequate disinfection measures under consideration of the
persistence and infectious dose of the pathogens. As a result, surface disinfection
is indicated in the following situations:
- Frequently touched surfaces adjacent to patients
- Surfaces with assumed or visible contamination
- Terminal disinfection in rooms or areas where infected or colonized patients
with easily transferable nosocomial pathogens are cared for, and
- in outbreak situations.
Furthermore, the knowledge of the persistence of pathogens will also support
ensuring the biosafety in microbiological and biomedical laboratories, food-
handling settings, and for hygienic behaviour in the everyday life to prevent
transmission of infectious diseases.
Keywords Persistence • Bacteria • Fungi • Viruses • Protozoa transmission
mechanisms • Surface disinfection
List of Abbreviations
HAI Healthcare-acquired infections
MRSA Methicillin-resistant Staphylococcus aureus
MSSA Methicillin-sensible Staphylococcus aureus
RH
Relative humidity
SARS
Severe acute respiratory syndrome
VRE
Vancomycin-resistant enterococci
2.1
Introduction
Microorganisms may be transmitted from animated sources to inanimate environ-
mental sources, which may become secondary reservoirs if they meet the needs of
transmitted pathogens to survive and to multiply. In healthcare settings, however,
contaminated surfaces, which may not always be optimal for microbial survival and
multiplication, still may play a role in the chain of infection, since surfaces close to
the patients' environment may be touched at high frequencies, allowing transmis-
sion from animated sources to others via contaminated inanimate surfaces.
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